Treatment for All Types of Stroke
People with a stroke who are admitted to our hospital receive care in the inpatient unit or intensive care unit, which features a critical care team highly experienced in the treatment of each type of stroke, including:
- Ischemic stroke: Happens when a blood clot blocks a vessel supplying blood to the brain. Ischemic strokes are often the result of carotid artery disease—a buildup of plaque inside the walls of neck arteries. This can impair blood flow to the brain.
- Hemorrhagic stroke or “brain bleed”: Results when a blood vessel in the brain ruptures. Most hemorrhagic strokes occur in people with high blood pressure. Poorly controlled hypertension can cause breaks in the tiny arteries deep within the brain.
With both types of stroke, the brain does not receive enough oxygen-rich blood, and brain cells die. Damaged brain tissue can cause neurological deficits. That is why an accurate diagnosis and prompt treatment from stroke experts are so essential.
How Do We Diagnose a Stroke?
NewYork-Presbyterian Brooklyn Methodist doctors use imaging techniques such as computed tomography (CT) scanning and magnetic resonance imaging (MRI) to diagnose strokes. They may also employ other exams to determine how much a stroke has affected brain function.
Ischemic Stroke Treatments
Medical treatments
Tissue plasminogen activator (tPA), a clot-busting medication for ischemic strokes, works well when it is given within four-and-a-half hours of the beginning of stroke symptoms in people who do not have brain bleeding. Rapid tPA treatment results in better outcomes and is a hallmark of the effective stroke care provided at NewYork-Presbyterian Brooklyn Methodist.
Surgical therapies
Our stroke team includes neurosurgeons with special training in endovascular treatment for ischemic strokes that do not get better with tPA alone. These approaches can also be useful in people for whom tPA is no longer a treatment option. Our team uses mechanical clot extraction, which involves inserting a special device through a catheter (flexible tube) threaded to the location of the blockage to remove the clot and restore blood flow. For some patients, combining tPA with endovascular treatment may be better for than tPA alone.
Preventing a second stroke
Our stroke care team may prescribe medications such as blood thinners, statins (cholesterol drugs), and blood pressure medications to reduce the chance of a second stroke. Some patients may have a procedure to remove clots or plaque in the carotid arteries, reroute the blood supply to bypass a blockage, or put in a stent (tiny mesh tube) to improve blood flow to the brain.
Care for Hemorrhagic Stroke
Nonsurgical treatments
Our team employs a range of approaches to enhance healing and recovery in people with bleeding in the brain. These include:
- Controlling high blood pressure and brain swelling
- Normalizing blood clotting
- Increasing the flow of oxygen-rich blood to brain tissue near the injury
- Regulating brain temperature to normal or below-normal levels to protect brain tissue
Surgical therapy
For patients who have large brain hemorrhages, our neurosurgeons relieve pressure in the skull caused by bleeding. If the stroke happens because of a weakened or defective blood vessel wall, we repair these areas to prevent more strokes. We may also be able to redirect blood flow to other vessels that supply blood to the same region of the brain.